Document Type

Article

Publication Date

4-2012

Abstract

Background: Residential health care has changed over time. Skilled nursing facilities (SNF) as an alternative to standard long-term care are understudied. Objective: To describe current prescribing patterns of medication use in two Indianapolis SNFs.

Method: Chart review to examine associations between medication use and outcomes such as weight changes, falls and re-hospitalization. Discharged patients had to be residents for at least 14 days.

Results: 35 charts were reviewed. 17 (48.6%) patients were male, 22 (62.9%) were Caucasian, 15 (42.9%) had Medicaid, 6 subjects (17%) visited the emergency department, 5 (14.3%) visited the hospital during their stay at the selected facilities, 14 (40%) suffered falls, 23 (65.7%) took antidepressants, 15 (42.9%) received antibiotics and 4 (11.4%) had high anticholinergic burden. Duration of stay ranged from 14-362 days (median 41), age ranged from 40-95 (median 75), number of diagnoses 4-23, mean 12 (±4.105), weight change from loss of 52# to gain of 35.7# (median -5.6), Beer’s violations 0-3, mean 0.46 (±0.761) for patients aged ≥65 and the maximum scheduled medications at one time 3-24, mean 9.26 (±4.273). Of the 15 (42.9%) patients that received antibiotics there were 24 instances of use, 19 (79.2%) of those fit the facilities criteria for appropriate use of antibiotics.

Conclusion: There are few associations between exposures: use of antibiotics or antidepressants, anticholinergic burden, or deviations from Beer’s criteria. This may be due to small sample size or be an indication of careful prescribing at these facilities.

Rights

This is an electronic copy of a Report prepared for Advanced Healthcare Associates. Archived with permission. The author(s) reserves all rights.

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